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Drug Overdose

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https://www.readbyqxmd.com/read/28723266/age-of-initiation-psychopathology-and-other-substance-use-are-associated-with-time-to-use-disorder-diagnosis-in-persons-using-opioids-nonmedically
#1
Ty S Schepis, Jahn K Hakes
BACKGROUND: Nonmedical use of prescription opioids (NMUPO) is an ongoing public health challenge, as NMUPO is associated with psychopathology, other drug use and fatal overdose. These concomitant risks are greatest in those with opioid use disorder (OUD), but the development of NMUPO-related use disorder is poorly understood. The primary aim of this study was to establish factors associated with the development of and time to OUD among persons engaged in NMUPO. METHODS: Data were from Wave 1 of the National Epidemiologic Study on Alcohol and Related Conditions, with 1,755 participants endorsing lifetime NMUPO...
July 19, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28718908/death-from-butane-inhalation-abuse-in-teenagers-two-new-case-studies-and-review-of-the-literature
#2
Véronique Alunni, Yvan Gaillard, François Castier, Marie-Dominique Piercecchi-Marti, Gérald Quatrehomme
The ready availability of butane makes butane abuse frequent. Fatalities are rare. This study presents two cases of death by butane overdose. The postmortem analyses were carried out using headspace gas chromatography-mass spectrometry. It revealed femoral blood butane concentrations of 18 and 22 mg/L, respectively, as well as specific combinations of adjuvants in each victim. In one of the victims, brain and fatty tissue also contained butane, pointing to chronic consumption. The originality of this study is to show that the identification of specific combinations of adjuvants can be helpful for identifying the brand of deodorant used...
July 18, 2017: Journal of Forensic Sciences
https://www.readbyqxmd.com/read/28716517/lethal-suicide-attempt-with-a-mixed-drug-intoxication-of-metoprolol-and-propafenone-a-first-pediatric-case-report
#3
Ivana Kacirova, Milan Grundmann, Martin Kolek, Erika Vyskocilova-Hrudikova, Romana Urinovska, Petr Handlos
INTRODUCTION: The β1 adrenergic receptor blocker metoprolol is often prescribed together with the antiarrhythmic drug propafenone. Both are metabolized by cytochrome P450 2D6 and propafenone is also an inhibitor of this enzyme. We present a pediatric case showing metoprolol and propafenone intoxication in combination. CASE: A 14-year-old girl was admitted to a local emergency department after ingestion of metoprolol (probably 1g) and propafenone (probably 1.5-3g) in a suicide attempt...
June 29, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28713798/incidence-and-severity-of-prescribing-errors-in-parenteral-nutrition-for-pediatric-inpatients-at-a-neonatal-and-pediatric-intensive-care-unit
#4
Theresa Hermanspann, Mark Schoberer, Eva Robel-Tillig, Christoph Härtel, Rangmar Goelz, Thorsten Orlikowsky, Albrecht Eisert
OBJECTIVES: Pediatric inpatients are particularly vulnerable to medication errors (MEs), especially in highly individualized preparations like parenteral nutrition (PN). Aside from prescribing via a computerized physician order entry system (CPOE), we evaluated the effect of cross-checking by a clinical pharmacist to prevent harm from PN order errors in a neonatal and pediatric intensive care unit (NICU/PICU). METHODS: The incidence of prescribing errors in PN in a tertiary level NICU/PICU was surveyed prospectively between March 2012 and July 2013 (n = 3,012 orders)...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28712878/antidepressants-are-cytotoxic-to-rat-primary-blood-brain-barrier-endothelial-cells-at-high-therapeutic-concentrations
#5
Ekramy Elmorsy, Ayat Al-Ghafari, Fahd M Almutairi, Amal Misbah Aggour, Wayne G Carter
Antidepressants are commonly employed for the treatment of major depressive disorders and other psychiatric conditions. We investigated the relatively acute cytotoxic effects of three commonly prescribed antidepressants: fluoxetine, sertraline, and clomipramine on rat primary blood brain barrier endothelial cells over a concentration range of 0.1-100μM. At therapeutic concentrations (0.1μM) no significant cytotoxicity was observed after 4, 24, or 48h. At high therapeutic to overdose concentrations (1-100μM), antidepressants reduced cell viability in proportion to their concentration and exposure duration...
July 13, 2017: Toxicology in Vitro: An International Journal Published in Association with BIBRA
https://www.readbyqxmd.com/read/28709467/amitriptyline-induced-ventricular-tachycardia-a-case-report
#6
Khandker Mohammad Nurus Sabah, Abdul Wadud Chowdhury, Mohammad Shahidul Islam, Bishnu Pada Saha, Syed Rezwan Kabir, Shamima Kawser
BACKGROUND: In Bangladesh, each emergency physician faces amitriptyline overdose nearly a day. An acute cardiovascular complication, one of the worst complications is mainly responsible for the mortality in tricyclic overdose. Recently, we managed ventricular tachycardia in a young female presented with an impaired consciousness 10 h after intentionally ingesting 2500 mg amitriptyline. Here, we report it, discuss how the electrocardiography is vital to acknowledge and predict it and its' complications and also the recent update of the management of it...
July 14, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28708699/flumazenil-for-mixed-drug-overdose
#7
Rukma Parthvi, Sunil Mehra
No abstract text is available yet for this article.
July 6, 2017: American Journal of Therapeutics
https://www.readbyqxmd.com/read/28694146/can-causality-assessment-fulfill-the-new-european-definition-of-adverse-drug-reaction-a-review-of-methods-used-in-spontaneous-reporting
#8
REVIEW
Annamaria Mascolo, Cristina Scavone, Maurizio Sessa, Gabriella di Mauro, Daniela Cimmaruta, Valentina Orlando, Francesco Rossi, Liberata Sportiello, Annalisa Capuano
Causality assessment is a fundamental biomedical technique for the signal detection performed by Pharmacovigilance centres in a Spontaneous reporting system. Moreover, it is a crucial and important practice for detecting preventable adverse drug reactions. Among different methods for causality assessment, algorithms (such as the Naranjo, or Begaud Methods) seem for their operational procedure and easier applicability one of the most commonly used methods With the upcoming of the new European Pharmacovigilance legislation including in the definition of the adverse event also effects resulting from abuse, misuse and medication error, all well-known preventable causes of ADRs, there was an emerging need to evaluate whether algorithms could fulfill this new definition...
July 7, 2017: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/28692945/impact-of-new-york-prescription-drug-monitoring-program-i-stop-on-statewide-overdose-morbidity
#9
Richard Brown, Moira R Riley, Lydia Ulrich, Ellen Percy Kraly, Paul Jenkins, Nicole L Krupa, Anne Gadomski
BACKGROUND: Prescription Drug Monitoring programs (PDMPs) are intended to reduce opioid prescribing and aberrant drug-related behavior thereby reducing morbidity and mortality due to prescription opioid overdose. Expansion of the New York (NY) State's PDMP in 2013 included the institution of the I-STOP law that mandated clinicians to consult the statewide PDMP database to review the patient's prescription history prior to prescribing opioids. METHODS: Trends in prescription opioid distribution, prescribing, and prescription opioid and heroin overdose morbidity in NY were analyzed using time series...
June 23, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28692407/overdose-history-is-associated-with-post-detoxification-treatment-preference-for-persons-with-opioid-use-disorder
#10
Michael D Stein, Jessica N Flori, Megan M Risi, Micah T Conti, Bradley J Anderson, Genie L Bailey
BACKGROUND: Without aftercare treatment, persons discharged from short-term inpatient detoxification for opioid use disorder are at high risk of relapse. In previous work, those who were recently homeless or had pending legal problems were more likely to prefer residential treatment for aftercare. Here, based on clinical experience, we hypothesize that a particular clinical factor, surviving an opioid overdose, will be associated with aftercare preference. METHODS: Between May and December 2015, we surveyed consecutive persons seeking inpatient opioid detoxification...
July 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28692400/developing-syndromic-surveillance-to-monitor-and-respond-to-adverse-health-events-related-to-psychoactive-substance-use-methods-and-applications
#11
Michelle L Nolan, Hillary V Kunins, Ramona Lall, Denise Paone
INTRODUCTION: Recent increases in drug overdose deaths, both in New York City and nationally, highlight the need for timely data on psychoactive drug-related morbidity. We developed drug syndrome definitions for syndromic surveillance to monitor drug-related emergency department (ED) visits in real time. MATERIALS AND METHODS: We used 2012 archived syndromic surveillance data from New York City hospitals to develop definitions for psychoactive drug-related syndromes...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28692390/use-of-emergency-department-data-to-monitor-and-respond-to-an-increase-in-opioid-overdoses-in-new-hampshire-2011-2015
#12
Elizabeth R Daly, Kenneth Dufault, David J Swenson, Paul Lakevicius, Erin Metcalf, Benjamin P Chan
OBJECTIVES: Opioid-related overdoses and deaths in New Hampshire have increased substantially in recent years, similar to increases observed across the United States. We queried emergency department (ED) data in New Hampshire to monitor opioid-related ED encounters as part of the public health response to this health problem. METHODS: We obtained data on opioid-related ED encounters for the period January 1, 2011, through December 31, 2015, from New Hampshire's syndromic surveillance ED data system by querying for (1) chief complaint text related to the words "fentanyl," "heroin," "opiate," and "opioid" and (2) opioid-related International Classification of Diseases ( ICD) codes...
July 2017: Public Health Reports
https://www.readbyqxmd.com/read/28690895/discrimination-between-drug-abuse-and-medical-therapy-case-report-of-a-tranylcypromine-overdose-related-fatality
#13
Maryam Akhgari, Farzaneh Jokar, Afshar Etemadi-Aleagha, Ali Ghasemi
Tranylcypromine is an effective antidepressant from the class of monoamine oxidase inhibitors and is structurally related to amphetamine. However, reports differ regarding the potential metabolism of tranylcypromine to amphetamine and methamphetamine within the human body. We report a 25-year-old woman with severe depression who died due to a fatal tranylcypromine overdose in 2016. She had been prescribed tranylcypromine one day previously and had no history of previous suicide attempts or substance abuse. The body was transferred to a forensic medicine department in Tehran, Iran for the autopsy...
May 2017: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/28690283/postmortem-computed-tomographic-analysis-of-death-caused-by-oral-drug-intoxication
#14
Akihito Usui, Yusuke Kawasumi, Kiyotaka Usui, Yuya Ishizuka, Kaito Takahashi, Masato Funayama, Haruo Saito
Traditional autopsy has changed little in the past century. In Japan, the rate of forensic autopsy in cases of unusual death is very low. Therefore, multi-slice computed tomography (CT) has been used to obtain imaging data instead of or in addition to autopsy in suspicious forensic cases. In our institute, postmortem multi-slice CT has been performed since 2009, and by 2014 there were over 1,000 cases. Our extensive experience with postmortem CT shows that in many cases of death by drug overdose, stomach contents exhibit high X-ray absorption...
2017: Tohoku Journal of Experimental Medicine
https://www.readbyqxmd.com/read/28689766/acute-administration-of-tramadol-and-tapentadol-at-effective-analgesic-and-maximum-tolerated-doses-causes-hepato-and-nephrotoxic-effects-in-wistar-rats
#15
Joana Barbosa, Juliana Faria, Sandra Leal, Luís Pedro Afonso, João Lobo, Odília Queirós, Roxana Moreira, Félix Carvalho, Ricardo Jorge Dinis-Oliveira
Tramadol and tapentadol are two atypical synthetic opioid analgesics, with monoamine reuptake inhibition properties. Mainly aimed at the treatment of moderate to severe pain, these drugs are extensively prescribed for multiple clinical applications. Along with the increase in their use, there has been an increment in their abuse, and consequently in the reported number of adverse reactions and intoxications. However, little is known about their mechanisms of toxicity. In this study, we have analyzed the in vivo toxicological effects in liver and kidney resulting from an acute exposure of a rodent animal model to both opioids...
July 6, 2017: Toxicology
https://www.readbyqxmd.com/read/28689643/suicide-means-among-decedents-aged-50-years-2005-2014-trends-and-associations-with-sociodemographic-and-precipitating-factors
#16
Namkee G Choi, Diana M DiNitto, C Nathan Marti, Mark S Kaplan, Yeates Conwell
OBJECTIVE: To examine 1) temporal trends between 2005 and 2014 in the three most frequently used suicide means (firearms, hanging/suffocation, alcohol/drug/medicine overdose) by decedents aged 50+ years and 2) associations of suicide means with sociodemographic and precipitating factors. METHODS: The National Violent Death Reporting System, 2005-2014, provided data (N = 46,857). Suicide means were identified from ICD-10 codes for underlying cause of death and coroner/medical examiner (CME) reports...
July 6, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28687187/naloxone-for-heroin-prescription-opioid-and-illicitly-made-fentanyl-overdoses-challenges-and-innovations-responding-to-a-dynamic-epidemic
#17
Nadia Fairbairn, Phillip O Coffin, Alexander Y Walley
Community-based overdose prevention programs first emerged in the 1990's and are now the leading public health intervention for overdose. Key elements of these programs are overdose education and naloxone distribution to people who use opioids and their social networks. We review the evolution of naloxone programming through the heroin overdose era of the 1990's, the prescription opioid era of the 2000's, and the current overdose crisis stemming from the synthetic opioid era of illicitly manufactured fentanyl and its analogues in the 2010's...
July 4, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28683056/vital-signs-changes-in-opioid-prescribing-in-the-united-states-2006-2015
#18
Gery P Guy, Kun Zhang, Michele K Bohm, Jan Losby, Brian Lewis, Randall Young, Louise B Murphy, Deborah Dowell
BACKGROUND: Prescription opioid-related overdose deaths increased sharply during 1999-2010 in the United States in parallel with increased opioid prescribing. CDC assessed changes in national-level and county-level opioid prescribing during 2006-2015. METHODS: CDC analyzed retail prescription data from QuintilesIMS to assess opioid prescribing in the United States from 2006 to 2015, including rates, amounts, dosages, and durations prescribed. CDC examined county-level prescribing patterns in 2010 and 2015...
July 7, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28682928/can-high-dose-levetiracetam-be-safe-a-case-report-of-prolonged-accidental-high-dose-levetiracetam-administration-and-review-of-the-literature
#19
Ayse Kartal
Levetiracetam is an antiepileptic drug that has been used both as adjunctive therapy and monotherapy in pediatric patients with epilepsy. We report a patient with cerebral palsy and epilepsy who took 200 mg/kg per day of levetiracetam for 55 days with no apparent adverse effects. Four other cases of accidental overdose were found in the literature; none of these was associated with any apparent adverse effects. These findings suggest that, in at least some cases, levetiracetam doses much higher than the recommended maximum of 60 mg/kg per day can be administered without apparent adverse effects...
July 4, 2017: Clinical Neuropharmacology
https://www.readbyqxmd.com/read/28681615/self-identification-of-nonpharmaceutical-fentanyl-exposure-following-heroin-overdose
#20
Matthew K Griswold, Peter R Chai, Alex J Krotulski, Melissa Friscia, Brittany Chapman, Edward W Boyer, Barry K Logan, Kavita M Babu
OBJECTIVE: To compare user self-identification of nonpharmaceutical fentanyl exposure with confirmatory urine drug testing in emergency department (ED) patients presenting after heroin overdose. METHODS: This was a cross-sectional study of adult ED patients who presented after a heroin overdose requiring naloxone administration. Participants provided verbal consent after which they were asked a series of questions regarding their knowledge, attitudes and beliefs toward heroin and nonpharmaceutical fentanyl...
July 6, 2017: Clinical Toxicology
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